ABSTRACT
Objective To estimate the effects of temperature on cardiovascular disease (CVD) deaths in 4 cities-Kunming,Changsha,Guangzhou and Zhuhai,from southern part of China.Methods Daily CVD deaths,meteorological and air pollution data were used to explore the association between temperature and mortality.Distributed lag non-linear model was fitted for each city to access the delayed and cumulative effects of low,median and high temperature on CVD deaths.Cold and hot effects of temperature on CVD deaths were then accessed,based on the linear threshold model.Results The city-specific exposure-response functions appeared to be non-linear.Temperatures that associated with the lowest mortality for Changsha,Kunming,Guangzhou and Zhuhai were 22.0 ℃,20.0 ℃,26.0 ℃,and 25.5 ℃.The greatest cumulative RRs (95％CI) for CVD deaths of low temperature during the delayed period of the study in the 4 cities were 1.858 (1.089-3.170),1.537 (1.306-1.809),2.121 (1.771-2.540) and 1.934 (1.469-2.548),while 1.100 (0.816-1.483),1.061 (0.956-1.177),1.134 (1.047-1.230) and 1.259 (1.104-1.436) for high temperatures in Changsha,Kunming,Guangzhou and Zhuhai respectively.The hot effect was greater than the cold effect on the current days.The hot effect was restricted to the first week,whereas the cold effect increased over the lag days,and then last for 3-4 weeks.Conclusion The city-specific exposure-response functions appeared to be non-linear.Both high and cold temperatures were associated with increased CVD deaths,but the impact of low temperature was more notable.Cold effect was delayed by several days but last for a longer period than the hot effect did.
ABSTRACT
Objective To investigate the changing trend of mortality and the spectrum regarding causes of death in the population of Hunan, and to analyze the health-related major diseases.Methods With retrospective study method, a sample survey on causes of death and the related information was carried out from 2004 to 2005 among the residents in Hunan province. Results were compared with the data from a retrospective survey on causes of death in Hunan during 1973-1975 and 1990-1992, respectively. Results The crude mortality rates and the standardized mortality ratios (SMR) of the reisidents in Hunan were 901.59/100 000 and 865.14/100 000 during the period of 1973-1975 while 588.64/100 000 and 537.42/100 000 druing the period of 1990-1992, and 608.27/100 000 and 413.67/100 000 during the period of 2004-2005, respectively. During the past 30 years, the SMR of the residents in Hunan decreased by 52.18% and the descending range from the rural areas was more than that of the urban areas, and higher in females than in males. The death proportion of infectious diseases, maternal and perinatal diseases, nutritional deficiencies decreased significantly (P＜0.01), but the death proportion of chronic non-communicable diseases increased significantly (P＜0.01). The changing ranges of the former two proportions were both larger in the rural areas than those in the urban areas. The highest proportions of deaths due to injury and poisoning during the past 30 years were both seen in the 5 year olds, followed by the age groups of 25 year olds (P＜0.01). During the period of 2004-2005, the death proportion of all the infectious diseases,maternal/perinatal diseases and nutritional deficiencies was 8.01% altogether, and those of chronic non-communicable diseases, injury and poisoning were 80.66% and 11.33%, respectively. During the past 30 years, the SMR of the three kinds of diseases all significantly decreased, more significantly seen in infectious diseases, maternal and perinatal diseases, and nutritional deficiencies but less in chronic non-communicable diseases. Among the death cases of chronic non-communicable diseases,the SMR of cerebrovascular disease, malignant tumor, and heart disease showed an increasing tendency and the sequences of them had been advanced to the first, the second, and the fourth in the death ranking during the period of 2004-2005, respectively. Conclusion The SMRs of the residents in the urban and rural areas from Hunan province showed a declining tendency.Cardiovascular, cerebrovascular diseases and malignant tumors had become the important diseases affecting the health of the people, while injury and poisoning had otherwise topped the causes of death among children and adolescents in Hunan province.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the time trends and age-related characteristics of mortality and disease burden for cardiocerebrovascular diseases (CVD) in Hunan, China during three periods (1973-1975, 1990-1992 and 2004-2005).</p><p><b>METHODS</b>The cardiocerebrovascular death data of Hunan residents were collected by three national retrospective sample surveys of death. Cause-specific mortality, proportion, years of potential life lost (YPLL) and associated indicators were identified in the population of Hunan in above mentioned three periods. Time trends of age-specific mortality rate were assessed by fitting curvilinear regression lines and the increase rates of mortality with age were analyzed in each period.</p><p><b>RESULTS</b>The standard all-cause mortality of residents in Hunan decreased (chi2 = 189.947, P < 0.001, chi2 = 54.201, P < 0.001; chi2 = 27,396.898, P < 0.001) while the standard mortality for CVD increased (chi2 = 54.201, P < 0.001; chi2 = 27,396.898, P < 0.001) from 1973 to 2005. The age-specific mortality rate for CVD increased with age in all three periods, especially for citizens older than 60 years. There were age stages in each period in which the mortality increase rate was the fastest (10-14 and 15-19 years old in 1973-1975; 10-14, 15-19 and over 80 years old in 1990-1992; 15-19 and over 80 years old in 2004-2005). Exponential regression function (y = b0e(b1x)) can be used for the proper description of age-specific mortality change. The ratio of YPLL for CVD in all death causes showed increase trend (chi2 = 275,630.407, P < 0.001). YPLL rate (YPLLs per 1000) in 1973-1975 was higher than those in 1990-1992 and 2004-2005. YPLL rate was positively correlated with mortality in all periods.</p><p><b>CONCLUSIONS</b>The mortality for CVD increased with time and aging. People older than 60 years were threatened by CVD mostly. Mortality trend analysis also found higher CVD deaths in people age 15-19 in Hunan residents.</p>